Chondrosarcoma occurring in a patient with polyostotic fibrous dysplasia

A 36-year-old white man with polyostotic fibrous dysplasia was found to have a high-grade chondrosarcoma arising from the left ilium. Although a left hemipelvectomy was performed, the patient subsequently developed sacral and pulmonary metastases and succumbed to his disease. This patient represents the first documented example of an unequivocally high-grade chondrosarcoma arising in an area of fibrous dysplasia without prior irradiation.     

Positivity of extrapulmonary Ga-67 uptake in sarcoidosis: Thyroid uptake due to chronic thyroiditis and bone uptake due to fibrous dysplasia

Ga-67 citrate scintigraphy was performed on a 29-year-old man who had been diagnosed as having pulmonary sarcoidosis by a transbronchial lung biopsy. A Ga-67 citrate scintigram showed increased uptake not only in the pulmonary hilum and mediastinum, but also in the thyroid gland and the right ilium. Chronic thyroiditis was confirmed by aspiration biopsy of the thyroid gland, and fibrous dysplasia was confirmed by CT guided biopsy of the right ilium. Extrapulmonary Ga-67 uptake in patients with sarcoidosis does not necessarily indicate the involvement of other tissues and organs.     

Tc-99m MIBI imaging in malignant fibrous histiocytoma

The authors report a case of malignant fibrous histiocytoma of the left forearm demonstrated by Tc-99m MIBI imaging. The tumor originated in the soft tissue of the forearm; no obvious bone invasion or metastasis was detected scintigraphically or radiologically.     

Positive gallium-67 citrate uptake in a patient with polyostotic fibrous dysplasia

Fibrous dysplasia is an uncommon bone condition with characteristic radiologic features. It is well known that there is increased uptake of Tc-99m hydroxymethylene diphosphonate (HMDP) and methylene diphosphonate (MDP) in fibrous dysplasia. There are no reports of uptake of Ga-67 citrate by fibrous dysplasia. A case is reported in which positive Ga-67 uptake was seen in a patient with polyostotic fibrous dysplasia.     

Aggressive fibrous dysplasia of the maxillary sinus

Fibrous dysplasia is usually a slowly progressive, benign disease that develops over several years and presents with deformity or mild symptomatology. Five of 34 patients (ages 4–21 years), who were subsequently diagnosed histologically as having fibrous dysplasia of the maxillary sinus, rapidly developed soft tissue masses of the malar region over a period of less than 4 months with accompanying pain (2 patients) and nasal obstruction and exophthalmos (2 patients). Each was clinically suspected of having a sarcoma; two had been thought to have an osteofibrosarcoma on initial biopsy at outside hospitals. After resection, all lesions developed regrowth. At histopathologic examination, both initial and recurrent masses proved to be typical fibrous dysplasia with spicules of woven bone in cellular, sometimes vascular, fibrous tissue. No malignant degeneration was found.On conventional radiography, aggressive fibrous dysplasia produced opacification and expansion of the maxillary sinus and apparent disruption of its wall with an associated soft tissue mass. Computed tomography (CT) demonstrated voluminous heterogeneous masses with ground glass appearance, calcifications, areas of enhancement, low attenuation, cystic areas, and a thinned, sometimes interrupted, maxillary wall. Despite the aggressive clinical course for both initial and recurrent lesions, the CT findings of a ground glass mass with calcifications surrounded by a maxillary sinus wall, even if incomplete, can suggest the diagnosis of aggressive fibrous dysplasia.Deceased     

Discordant hepatic uptake between Tc-99m sulfur colloid and Tc-99m DISIDA in hypervitaminosis A

Scintigraphic findings in a patient with biopsy-proven hypervitaminosis A included markedly impaired hepatic uptake of Tc-99m sulfur colloid but essentially normal uptake of Tc-99m DISIDA . This case presents a potential cause for image discordance with these two agents.     

Osteosarcoma in fibrous dysplasia

Two cases are reported with osteosarcomatous transformation in fibrous dysplasia, one in the skull and one in the iliac bone. In both cases the patient was known to have longstanding polyostotic fibrous dysplasia; no radiation therapy was ever given. The incidence of sarcomatous transformation in fibrous dysplasia in the files of the Netherlands Committee on Bone Tumours is 0.5%. When strict criteria for spontaneous malignant transformation are used, the actual incidence is probably lower than is suggested.     

Discordant hepatic uptake of Tc-99m NGA and Tc-99m PMT in a patient with hepatoma.

The authors report discordant hepatic uptake of Tc-99m NGA and Tc-99m PMT in a patient with hepatoma. Tc-99m PMT uptake was delayed and Tc-99m NGA concentrated in another area, thereby demonstrating that the uptake mechanisms for Tc-99m NGA and Tc-99m PMT are different. Tc-99m NGA imaging may be useful in characterizing the focal hepatic lesion of Tc-99m IDA or Tc-99m PMT concentration.     

Cystic fibrous dysplasia mimicking giant cell tumor: MRI appearance

We report the case of a 43-year-old man who presented with an osteolytic and expansive lesion in the left distal femur mimicking a giant cell tumor. Magnetic resonance imaging (MRI) showed that most of the lesion was cystic, and histological examination revealed fibrous dysplasia with marked cystic degeneration. Radiographic findings of cystic fibrous dysplasia in the end of a long bone may be similar to those of a giant cell tumor, and a biopsy is essential for the final diagnosis. Received: 4 June 1999 Revision requested: 10 August 1999 Revision received: 13 September 1999 Accepted: 15 September 1999     

Tc-99m diphosphonate uptake in malignant fibrous histiocytoma: a possible iron-related effect

A man with malignant fibrous histiocytoma of the thigh had avid uptake of Tc-99m MDP in the lesion. Review of tissue sections showed considerable accumulation of iron in the tumor. Iron is known to be a potential nidus for deposition of the Tc-99m diphosphonates. A review was made of tissue sections from two other reported cases of malignant fibrous histiocytoma which also had significant accumulation of Tc-99m diphosphonates. Both revealed iron within the tumor. The origin of the iron is unknown (perhaps from necrosis and hemorrhage, from trauma, or from innate phagocytic activity of the histiocytes). However, this observation may serve as a stimulus to studies attempting to discern the underlying mechanisms of extraosseous deposition of the Tc-99m diphosphonates.